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Revista Brasileira de Educação Médica

Print version ISSN 0100-5502On-line version ISSN 1981-5271

Abstract

BARRETO, Ricardo Monteiro de Sá et al. Validation of a Simulated Laparoscopic Skills Training Program by Surgical Residents. Rev. Bras. Educ. Med. [online]. 2019, vol.43, n.2, pp.106-113. ISSN 1981-5271.  https://doi.org/10.1590/1981-52712015v43n2RB20180088.

Introduction

Training with simulators for video-surgery has been proposed as teaching tools, allowing formative evaluation of students under more controlled and safe conditions.

Objective

To validate structured program of endosuture training for surgical residents, through two structured scales of acquisition of laparoscopic skills and participant’s perception.

Methods

This was a quantitative longitudinal experimental study involving 12 residents of surgery from four different hospitals. The training consisted of making endorsements with video simulators in seven sessions over a period of seven months. The evaluation of the progression of the technical competence of the students was carried out by three evaluators, using the Objective Structured Assessmen of Technical Skills (Osats) and the Progression of Proficiency Scale (EPP) in Endorsements. Residents used a Likert scale to evaluate the training program. Anova and chi square tests were performed to compare variables. Correlations and associations between two numerical variables were verified through simple and multiple linear regression, when the determinants were included in addition to the number of training sessions. The Average Ranking was calculated for Likert scale analysis. Comparisons with p value ≤ 0.05 were considered significant.This study was approved by the Research Ethics Committee of the institution.

Results

There was a significant gain in the acquisition of technical competence by the residents during the course, perceived through the two evaluation instruments used (Osats and EPP). As regards the performance of the residents observed by the evaluators through the Osats, there was a statistically significant improvement in the score in relation to the items: Respect to the tissue (p = 0.006), Time and movement (p = 0.001), Knowledge and handling of instruments p = 0.002), Circulation flow (p = 0.001), Knowledge of the specific procedure (p = 0.001), by the chi-square test. In relation to the total number of points by EPP and the mean score in the tests by the modified Osats, the total and the mean score in the tests were significant (< 0.001 and < 0.001), using the Kruskal-Wallis test, over the months training. In the students’ perception, the training program contributed to the development of surgical skills, with the best evaluated items being the handling of tweezers and needle holders and the knitting. The worst evaluated items were the hapticity and the gait step.

Conclusion

There was a significant gain in skills by the residents of surgery during the seven months of simulated training, demonstrated in two structured assessment instruments and by the residents’ perception.

Keywords : Simulation Training; Laparoscopy; Internship and Residency.

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